Automated ABR Screening for Hearing Loss and its Clinical Determinants among Newborns with Hyperbilirubinemia in National Hospital, Abuja, Nigeria

Abstract

Background: Severe neonatal hyperbilirubinemia is a known risk factor for sensorineural hearing loss which is usually undiagnosed in  our environment until school age due to a lack of routine screening programs.

Materials and Methods: This cross-sectional study  conducted between August 2020 and February 2021 employed a universal sampling of consecutive eligible participants after their  mothers’ consent. Hearing screening was conducted using an automated auditory brainstem response (AABR) device (Otoport OAE +  ABR®). The proportion of AABR screening failure was assessed while associated clinical risk factors were determined using logistic  regression. Statistical significance was set at 5% for all comparative analyses.

Results: One hundred and sixty newborns below 28 days of  age, delivered at 34 weeks gestation and above, who had jaundice were recruited. The prevalence of screening AABR failure in at least  one ear was 26.2%. Significant risk factors for AABR screening failure in addition to extreme and hazardous hyperbilirubinemia were  acute bilirubin encephalopathy (ABE) (Odds Ratio (OR) =4.44, 95% CI = 3.19-6.17), birth weight below 2500 g (OR = 3.16, 95% CI =  1.48-6.77), dull tympanic membrane (TM) (OR = 5.94, 95% CI = 2.36-14.92) and exchange blood transfusion (OR = 4.84, 95% CI =  1.87-12.58).

Conclusion and Recommendations: The prevalence of AABR screening failure was high, and a dull TM was its strongest  predictor among late reterm and term neonates with hyperbilirubinemia. Otoscopy should be included in the care of newborn with  hyperbilirubinemia and screening programs established to mitigate hearing loss among high-risk neonates in Abuja.